Spreading the Word on Family Planning

The green terrain of Ambasel woreda in South Wollo, Ethiopia, is
breathtaking. However, life in this mountainous region is not easy, and
with rainfall unpredictable, people struggle just to make ends meet.
Life is particularly difficult for large families, given increasing
pressure on the land. In the words of Almaz Kibri, a community health
volunteer, “These people are barely above the grave.”

That is precisely why villagers in Ambasel woreda have started to
consider family planning to be “God-sent.” It has brought hope to many
villagers since it was introduced nine years ago.

Almaz herself has come a long way since she learned about family
planning about eight years ago. “I first heard about it from my eldest
son, who learned of it at a school in Wuchale Town. My son was only 12
years then, but they have taught him about the benefits of family
planning to the mother and child in particular and to the family in
general,” she says. “At first, the family was not very keen on this, but
we started to discuss my son’s idea from time to time and soon I
started to see his point. After some time, I heard about family planning
from a health extension worker in my kebele. When I told the health
extension worker that I’d like to start to take the pills, she couldn’t
believe it. Soon, the whole family realized the benefits of family
planning. I even apologized to my son for disparaging his suggestion.”

Almaz began using oral contraceptives, and she now talks openly about
the benefits of family planning. “Family planning is the single most
important thing that happened to me. Thanks to family planning, I can
send all my children to school. I have the time to take care of my
children. I have no worries of pregnancy and pregnancy-related death. I
can afford the time to work on the farm. My family is a lot happier,
wealthier, and healthier, and it’s all because of family planning.”

After using oral contraceptives for eight years, Almaz recently
decided to switch to a permanent method—female sterilization. “Taking
pills every day for so long has its inconvenience,” she points out. “I
was a bit worried about side effects too. When I first heard about this
permanent contraception, I jumped at the chance. I am grateful to the
people who brought the service to my town. I certainly don’t want any
more children, and why bother about pills every day?”

Almaz, 35, was able to access the service at a government hospital
where EngenderHealth’s Access to Better Reproductive Health Initiative
was training doctor-nurse teams on permanent family planning methods.
Just one week after the procedure, Almaz is thrilled. “I had a
sterilization procedure that was painless and performed very quickly,
and I’m now healthy and happy. I’m also very eager to spread the good
news to fellow villagers. I know that there are a lot of people out
there who desperately need the service but don’t have the information.”

Almaz will have help in spreading the word. She was among a group of
community health volunteers recently trained by EngenderHealth in
collaboration with the Amhara Development Association and the Federal
Ministry of Health. The training focused on helping volunteers conduct
one-on-one counseling sessions in homes and lead community dialogue
sessions with women and men, based on guidelines developed by
EngenderHealth.

The purpose of these discussions and home visits is to encourage the
community to explore the benefits of family planning and address
barriers to long-acting and permanent methods on their own. Almaz is
looking forward to sharing her knowledge with others in her community
and supporting both women and men in adopting family planning, including
long-acting and permanent methods.

Almaz’s commitment to promoting family planning is not based solely
on her personal experience with its benefits. She has seen firsthand the
tragic toll of frequent childbearing: “When I think of family planning,
I think of my neighbor who died while giving birth to her 10th child
about six years ago,” Almaz recalls. “She had nine children, and I know
that another child was the last thing she wanted in her life. There was,
however, nothing she could do about it. Family planning was not readily
available then, or at least she did not have information about it. She
would not have died if she had the chance that women like me have
today.”

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"Family planning is the single most
important thing that happened to me," says Almaz.